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Annular Tears

scaredofsurgerysscaredofsurgery Posts: 20
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
I have been diagnosed with DDD in the Lumbar region of the spine. I am going for my second MRI. The first MRI I had done showed an Annular Tear that looks pretty small. What it looks like now, will be determined through the new MRI. Anyway, my question is, do all Annular Tears require surgery? Can I go through physical therapy to remedy the problem? I have pain that goes down my leg, but mainly it feels like someone really kicked me in my lower butt...LOL.
And it hurts like crazy to sit. And I have zero reflex in my right achilles heel.
Can anyone here please give me some input? Surgery, no surgery? Physical Therapy...etc.
Thanks....
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1

Comments

  • my last MRI showed a vary large tear at L5 s1 i have been to 2 ortho surgeons they say small ones usually heal on there own and large ones sometimes can to in 2 to 5 years if at all. my physical therapy doc stopped he say the phy activity would just aggravate the prob witch it dose.
    surgery the accepted one at this time is fusion (not by me yet.kinda like burning down the house because you saw a mouse ) there are a few more i am sure you can search on hear and find them . ya feels like kicked in the back, but, leg,foot, burning and elect jolts , cant sit stand walk lay on left side more more than 15 min cannot get conferable always hurts. but that's me every one is different good luck with new mri let us no how it goes
  • I had a annular tear with a herniated disc that was not seen on the second MRI I had but now I have DDD and I still feel the same pain as before so I guess the Drs want to see where the pain is coming from the tear or the discs. Have you seen a Neurologist yet? I saw the Neurologist the same day my Primary booked my EMG/nerve test to check out compressed nerve causing numbness. Keep us up to date how you're doing. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • Hi scaredofsurgery,

    You cannot determine size of annular tear with MRI. That can be achieved by CT controlled discography.

    Some annular tears do heal, some do not. They are very hard to treat and cure. Ultimate solutions are fusion and ADR, but this are very invasive surgeries.

    Minimally-invasive altenatives for annular tears could be:
    1. PLDD - laser disc surgery
    2. Biacuplasty
    3. Sometimes nucleoplasty co-ablation.
    scaredofsurgery said:
    I have been diagnosed with DDD in the Lumbar region of the spine. I am going for my second MRI. The first MRI I had done showed an Annular Tear that looks pretty small. What it looks like now, will be determined through the new MRI. Anyway, my question is, do all Annular Tears require surgery? Can I go through physical therapy to remedy the problem? I have pain that goes down my leg, but mainly it feels like someone really kicked me in my lower butt...LOL.
    And it hurts like crazy to sit. And I have zero reflex in my right achilles heel.
    Can anyone here please give me some input? Surgery, no surgery? Physical Therapy...etc.
    Thanks....
  • Thank you all for your replies. I actually was supposed to have my closed MRI today, but I couldnt do it. They wouldnt let my sister in with me, so I had to reschedule for an open MRI instead.
    If I try the physical therapy like water therapy,do you think it will help? I get the feeling that I will have this for the rest of my life. I dont want to live this way and I am scared to have surgery. If they had a surgical procedure that was a guarantee then I would do it. The procedures like CT discography, is that one where you are awake and its sheer torture? I am already in pain, I dont want to hurt myself more by doing that. Will I be in pain like this for the rest of my life?
  • Very painful discography is modern myth. If performed by experienced dcotor with light local anesthetic, it should provoke similar pain to your everyday pain, not much higher.
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  • In my opinion, if you are going to try and heal a tear in the annulus, you will need to create an environment which will help your body do so...

    Stop smoking if you do. Constricts blood flow and isn't doing your body ANY good.

    Drink plenty of water, stop drinking soda. Corn syrup is just bad for you anyway.

    The annulus is made up of Collagen types I, II, and III. It makes sense that if you encorporate those supplements in your diet, the raw materials will be there to aid in healing.

    Maybe an inversion table. Since blood supply drops off to the discs themselves around the age of 28, the avenue of blood supply for repair is through the vertebral endplates mainly. The up and down, shock absorber motion draws in nutrients and hydrates the disc. That is why when you wake up in the morning, you are typically a half inch taller than when you went to bed. An inversion table may also help with alignment issues and muscle pain. Please seek professional help for its use as to your specific condition.

    Annular tears can heal from what I understand, but they take years depending how bad they are.

    PLDD, IDET, Nucleoplasty are still pretty investigational as a treatment for annular tears. I know Keano will jump on me, but pumping those treatments constantly doesn't make me think they will work any better than what my surgeons/doctors have told me. Buyer beware I suppose.

    If I think of anything else, I will post it later.

    Good luck and I hope you feel better soon!

    ~BB
  • buckeyeback said:

    PLDD, IDET, Nucleoplasty are still pretty investigational as a treatment for annular tears. I know Keano will jump on me, but pumping those treatments constantly doesn't make me think they will work any better than what my surgeons/doctors have told me. Buyer beware I suppose.
    ~BB
    Patient do not know what are their options.

    In recent years, PLDD, endoscopy, biacluplasty and some other treatments have been developed and can help patient (not all patients of course). That is the only truth, you need to accept it. Case studies and scientific papers stand behind this.

    I cannot comment on your doctors suggestions, or better said - I cannot comment on why your doctor had not suggested something.

    First of all, doctor needs to be educated about certain procedure before he can actually comment on it or suggest it. Many of surgeons avoid minimally-invasive and less-invasive treatments only because they don't know much about it, and they don't want to advance their practice. This will change very soon with rapid advancement of minimally-invasive procedures.

    Edit: but at the end, I can agree with one part of your reply. Biacuplasty is investigational as treatment option for annular tears and IDD, but reading some of case studies really shows good prospects.
    But for the laser this is just not true, especially to PLDD method acc. to Choy. Its been around for 24 years already.
  • An infrared heating pad. It can aid in drawing blood to the lower back and the infrared actually penetrates deep within the body in contrast to a regular heating pad which does not. They are not cheap. Google it and you'll find 'em online. Do some research on infrared heating pads. It's worth a look.

    ~BB
  • First of all, doctor needs to be educated about certain procedure before he can actually comment on it or suggest it. Many of surgeons avoid minimally-invasive and less-invasive treatments only because they don't know much about it, and they don't want to advance their practice. This will change very soon with rapid advancement of minimally-invasive procedures.


    Who pays for these procedures? YOU, the patient? NO self insured companies and Insurance companies do. If these types of procedured do not work, then it's $25-$30,000 down the drain. I have had a laser surgery which in my opinion the PLDD is inferior to and I'm not any better now. Matter of fact, I am a little worse in my opinion. I read testimonials, studies, etc. too before I had the procedure. I think if there was a long lasting track record of success, insurance companies would much rather do those procedures instead of the expensive fusion or ADR.

    I've had 3 medical professionals NOT support those treatments (IDET/Nucleoplasty).

    Everyone should do their own due diligence though.

    ~BB
  • If you talk about Accurascope, we can talk a lot of about it. I have investigated their procedure, and discussed about it with some leading names of minimally-invasive spine surgery, and nobody is impressed with it. I was trying to find some technical information about it, the laser energy they use... Only concrete that I found is that they use Th:Yag energy, and Google does not have any information about it. Also, there is NOT EVEN ONE scientific paper about Accurascope published in any of relevant medical journals. That is why Accurascope is incomparable to PLDD.

    I fully agree with you over IDET and Nucleoplasty. IDET has been abandoned by many spinal surgeons, and nucleoplasty success is very doubtful. However, I have noted neucleoplasty as less-invasive possibility to help with annular tear and postpone some more invasive surgery.
    buckeyeback said:

    Who pays for these procedures? YOU, the patient? NO self insured companies and Insurance companies do. If these types of procedured do not work, then it's $25-$30,000 down the drain. I have had a laser surgery which in my opinion the PLDD is inferior to and I'm not any better now. Matter of fact, I am a little worse in my opinion. I read testimonials, studies, etc. too before I had the procedure. I think if there was a long lasting track record of success, insurance companies would much rather do those procedures instead of the expensive fusion or ADR.

    I've had 3 medical professionals NOT support those treatments (IDET/Nucleoplasty).

    Everyone should do their own due diligence though.

    ~BB
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